Browsing by Author "van der Meer, Graeme"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Open Access
    Paediatric Nasopharyngeal Airways (PNA)
    (University of Cape Town, 2025-03-08) Alvo, Andrés; Sedano, Cecilia; van der Meer, Graeme; Fagan, Johan
    A paediatric nasopharyngeal airway (PNA) is an airway adjunct consisting of a hollow plastic tube designed to stent the nose and nasopharynx. Depending on the level of the obstruction the PNA will terminate in the nasopharynx, oropharynx or hypopharynx. It is better tolerated than an oropharyngeal (Guedel) airway and has the advantage that it can be used in patients with an intact gag reflex, trismus and oral trauma. Although PNAs have mainly been used in emergency and anaesthetic medicine, they are being increasingly used in paediatric otolaryngology. PNAs can be used to alleviate obstruction at any level from the anterior nasal cavity to the oropharynx (Table 1). They are often used to maintain airway patency in patients with a high risk of developing postoperative respiratory complications after adenotonsillectomy.
  • No Thumbnail Available
    Item
    Open Access
    Supraglottoplasty for Laryngomalacia
    (University of Cape Town, 2025-04-18) Jonas, Nico; van der Meer, Graeme; Fagan, Johan
    Laryngomalacia is characterised by collapse of the supraglottic tissues on inspiration. It is the most common cause of stridor in infancy. It generally becomes symptomatic 2-3 weeks after birth, and presents as characteristic high-pitched, inspiratory, squeaking stridor. Classically symptoms are worse in the supine position, when the child cries, or is agitated. Males are affected twice as often as females. It usually resolves by the age of 2 years. Laryngomalacia may remain symptomatic beyond 2 years in patients with neuromascular disorders and should be considered in the differential diagnosis of inspiratory stridor even in older children. The aetiology is not fully understood. There does appear to be a familial predisposition. Anatomically, redundant supraglottic soft tissues collapse on inspiration and cause supraglottic airway obstruction. Another theory is that of immature neuromuscular development causing supraglottic compromise. A common coexisting condition is that of acid reflux which may exacerbate laryngomalacia by causing posterior supraglottic oedema.